Provider Demographics
NPI:1538520432
Name:LEBAR, MELISSA PROFFITT (PHARMD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:PROFFITT
Last Name:LEBAR
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DAWN
Other - Last Name:PROFFITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3215 NOTTINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-8906
Mailing Address - Country:US
Mailing Address - Phone:785-550-7742
Mailing Address - Fax:785-331-0878
Practice Address - Street 1:335 SW MACVICAR AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2441
Practice Address - Country:US
Practice Address - Phone:785-379-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-19
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
416708OtherNABP